{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T13:48:09Z","timestamp":1770904089969,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,17]],"date-time":"2024-03-17T00:00:00Z","timestamp":1710633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005039","name":"Leids Universitair Medisch Centrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005039","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Red blood cell autoimmunity and alloimmunity are potentially linked. Quantification of this association can tailor extensively matched red blood cell transfusions in patients with autoimmunity. Using an incident new\u2010user cohort comprising 47\u2009285 previously non\u2010transfused, non\u2010alloimmunised patients, we compared transfusion\u2010induced red blood cell alloimmunisation incidences in direct antiglobulin test (DAT)\u2010positive and control patients. Additionally, we performed case\u2013control analyses to handle potential confounding by clinical immunomodulators. Among (IgG and\/or C3d) DAT\u2010positive patients (<jats:italic>N<\/jats:italic>\u2009=\u2009380), cumulative red blood cell alloimmunisation incidences after 10\u2009units transfused reached 4.5% (95% confidence interval [CI] 2.5\u20138.2) versus 4.2% (CI 3.9\u20134.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.88) in controls. In case\u2013control analyses, alloimmunisation relative risks among DAT\u2010positive patients increased to 1.7 (CI 1.1\u20132.8). Additional adjustments for pre\u2010DAT transfusion exposure or the extent of Rh\/K mismatching did not impact results. In conclusion, while patients with DAT positivity show an intrinsically increased alloimmune red blood cell response, their absolute risk is comparable to control patients due to counteracting co\u2010existing immunosuppressive conditions. Consequently, isolated DAT positivity in patients lacking overt haemolysis or complicated alloantibody testing does not seem to warrant extended matching strategies.<\/jats:p>","DOI":"10.1111\/bjh.19354","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T02:09:35Z","timestamp":1710727775000},"page":"2103-2111","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenging the dogma: Red blood cell\u2010directed autoimmunity as risk factor for red blood cell alloimmunisation after blood transfusion"],"prefix":"10.1111","volume":"204","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8985-6627","authenticated-orcid":false,"given":"Josine A.","family":"Oud","sequence":"first","affiliation":[{"name":"Center for Clinical Transfusion Research, Sanquin Research  Leiden The Netherlands"},{"name":"Department of Haematology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masja","family":"de Haas","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research, Sanquin Research  Leiden The Netherlands"},{"name":"Department of Haematology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Immunohaematology Diagnostics Sanquin  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M. K.","family":"de Vooght","sequence":"additional","affiliation":[{"name":"Central Diagnostic Laboratory University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daan","family":"van de Kerkhof","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Haematology Catharina Hospital  Eindhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nel","family":"Som","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Amsterdam University Medical Center, Location VUmc  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie C. V.","family":"P\u00e9qu\u00e9riaux","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Haematology Jeroen Bosch Hospital  's\u2010Hertogenbosch The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisca","family":"Hudig","sequence":"additional","affiliation":[{"name":"LabWest, Haga Teaching Hospital  The Hague The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna G.","family":"van der Bom","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research, Sanquin Research  Leiden The Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-4682","authenticated-orcid":false,"given":"Dorothea","family":"Evers","sequence":"additional","affiliation":[{"name":"Department of Haematology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaap Jan","family":"Zwaginga","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research, Sanquin Research  Leiden The Netherlands"},{"name":"Department of Haematology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.175752"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537\u20102995.2003.00549.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15182"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12914"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13781"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.11.028"},{"key":"e_1_2_10_8_1","unstructured":"Dutch Blood Transfusion Guideline [Internet]. 2019. 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